How Much Cerebrospinal Fluid Should We Remove Prior to Measuring a Closing Pressure?

2016 ◽  
Vol 32 (4) ◽  
pp. 356-359 ◽  
Author(s):  
Son H. McLaren ◽  
Michael C. Monuteaux ◽  
Atima C. Delaney ◽  
Assaf Landschaft ◽  
Amir A. Kimia
Keyword(s):  
Cerebrospinal Fluid ◽  
Polynomial Regression ◽  
Pressure Change ◽  
Cross Sectional Study ◽  
Inclusion Criteria ◽  
Opening Pressure ◽  
Cross Sectional ◽  
Csf Pressure ◽  
Fractional Polynomial ◽  
Closing Pressure

Objective: The objective of this study was to identify a relationship between cerebrospinal fluid (CSF) volume removal and change in CSF pressure in children with suspected idiopathic intracranial hypertension (IIH). Methods: We performed a cross-sectional study of children 22 years and younger who underwent a lumbar puncture (LP) and had a documented opening pressure, closing pressure, and volume removed. Relationship between volume removal and pressure change was determined using a fractional polynomial regression procedure. Results: In the 297 patients who met the inclusion criteria, CSF pressure decreased by 1 cm H2O for every 0.91 mL of CSF removed if the maximum change in pressure was less than 15 cm H2O ( R2 = 0.38). Conclusion: A linear relationship exists between the volume of CSF removed and the amount of pressure relieved when the desired pressure change is less than 15 cm H2O.

scholarly journals Cerebrospinal fluid closing pressure-guided tap test for the diagnosis of idiopathic normal pressure hydrocephalus: A descriptive cross-sectional study

2020 ◽  
Vol 11 ◽  
pp. 315
Author(s):  
Diego Fernando Gómez-Amarillo ◽  
Luis Fernando Pulido ◽  
Isabella Mejía ◽  
Catalina García-Baena ◽  
María Fernanda Cárdenas ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Opening Pressure ◽  
Cross Sectional ◽  
Tap Test ◽  
The Mean ◽  
Closing Pressure

Background: Tap test improves symptoms of idiopathic normal pressure hydrocephalus (iNPH); hence, it is widely used as a diagnostic procedure. However, it has a low sensitivity and there is no consensus on the parameters that should be used nor the volume to be extracted. We propose draining cerebrospinal fluid (CSF) during tap test until a closing pressure of 0 cm H2O is reached as a standard practice. We use this method with all our patients at our clinic. Methods: This is a descriptive cross-sectional study where all patients with presumptive diagnosis of iNPH from January 2014 to December 2019 were included in the study. We used a univariate descriptive analysis and stratified analysis to compare the opening pressure and the volume of CSF extracted during the lumbar puncture, between patients in whom a diagnosis of iNPH was confirmed and those in which it was discarded. Results: A total of 92 patients were included in the study. The mean age at the time of presentation was 79.4 years and 63 patients were male. The diagnosis of iNPH was confirmed in 73.9% patients. The mean opening pressure was 14.4 cm H2O mean volume of CSF extracted was 43.4 mL. Conclusion: CSF extraction guided by a closing pressure of 0 cm H2O instead of tap test with a fixed volume of CSF alone may be an effective method of optimizing iNPH symptomatic improvement and diagnosis.

scholarly journals Chinese Fetal Biometry: Establishment of a Formula for Calculating Gestational Age based on Crown–Rump Length Measurements

2021 ◽  
Author(s):  
Yixiu Zhang ◽  
Hua Meng ◽  
Yuxin Jiang ◽  
Zhonghui Xu ◽  
Yunshu Ouyang ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Gestational Age ◽  
Prediction Error ◽  
Polynomial Regression ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Crown Rump Length ◽  
Fetal Biometry ◽  
Fractional Polynomial ◽  
The Mean

Abstract Background: To develop an ultrasonographic dating formula for predicting gestational age (GA) based on fetal crown–rump length (CRL) in a Chinese population, evaluate its systematic prediction error and compare it with existing formulae.Methods: This was a prospective cross-sectional study of spontaneously conceived singleton pregnancies among women with a regular menstrual cycle in the preceding year. Ultrasound examinations were performed at 11–14 weeks according to the date of the last menstrual cycle. The CRL was measured three times for each fetus, and the mean was used to derive the best-fit fractional polynomial regression model for estimation of GA in relation to CRL. For each fetus, the GA was compared with the GA calculated using six established dating formulae based on CRL measurements. The means of the differences between estimated and menstrual age were calculated for each formula. All the women were followed up routinely until the birth of the fetus. Results: Of the 4710 subjects recruited, the mean and standard deviation values of CRL changed linearly with GA. The corresponding regression equation and its correlation coefficient (R2) was GA = 59.361513 + 0.461425 ´ CRL (R2 = 0.8028). The mean difference between estimated and menstrual age was 0.22 days (95% confidence interval 0.05–0.21), lower than that of the six existing CRL dating formulae.Conclusions: We have derived a CRL-based dating formula suitable for naturally conceived pregnancies for GA between 11+0 and 13+6 weeks. The formula has no systematic prediction error, comparing favorably with the existing published dating formulae.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

scholarly journals Assessment of Saudi Parents’ Beliefs and Behaviors towards Management of Child Fever in Saudi Arabia—A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5217
Author(s):  
Mohamed N. Al Arifi ◽  
Abdulrahman Alwhaibi
Keyword(s):  
Saudi Arabia ◽  
Side Effects ◽  
Febrile Seizures ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Electronic Thermometer ◽  
And Behavior

Objective: Fever alone can lead to rare serious complications in children, such as febrile seizures. The aim of this study is to assess the knowledge, beliefs, and behavior of parents toward fever and its management. Methods: A cross-sectional study using an online questionnaire was applied over a period of 3 months, from January to March 2018, to parents who were living in Saudi Arabia. The inclusion criteria were a parent who is a resident of Saudi Arabia, with at least one child aged 6 years or less, while incomplete questionnaires, having a child aged more than 6 years, or parents who were not living in Saudi Arabia were excluded. Results: A total of 656 parents completed the questionnaire. More than two-thirds of the subjects were female, the majority of whom were aged between 25–33 years old. The best-reported place to measure the temperature of children was the armpit (46%), followed by the ear (28%) and the mouth (10.7%). More than half of the parents considered their children feverish at a temperature of 38 °C. The majority of parents (79.7%) reported that the most serious side effects of fever were seizure, brain damage (39.3%), coma (29.9%), dehydration (29.7%), and death (25%). The most common method used to measure a child’s temperature was an electronic thermometer (62.3%). The most common antipyretic was paracetamol (84.5%). Conclusions: Our study demonstrates the good knowledge of parents in identifying a feverish temperature using the recommended route and tools for measuring body temperature.

Violence Against Women During COVID-19 Pandemic

2021 ◽  
pp. 088626052199795
Author(s):  
Marwan Akel ◽  
Jana Berro ◽  
Clara Rahme ◽  
Chadia Haddad ◽  
Sahar Obeid ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Married Couples ◽  
Self Esteem ◽  
Cross Sectional Study ◽  
Economic Factors ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Living Together ◽  
Stress Score

The objectives of this study were to correlate several factors - including depression, anxiety, stress and self-esteem levels in both men and women - with the occurrence of domestic violence against women (VAW) during quarantine. This cross-sectional study was carried out in April 2020, in the midst of the COVID-19 pandemic when lockdown procedures were implemented; 86 married couples participated in this study amounting to 172 responses in total. A different questionnaire was set for women and men; the couple filled out their respective questionnaire simultaneously, but privately where one did not see the answers of the other. Inclusion criteria included married couples of all ages that are living together during the lockdown of COVID-19. The results of this study showed that a higher total abuse score was found in 39 females (45.3%; CI: 0.34 - 0.56). Being a Muslim female (Beta =24.80) and females having higher anxiety (Beta=0.97) were significantly associated with higher total abuse scores, whereas higher stress score in female (Beta=-0.61) was significantly associated with lower total abuse scores. In conclusion, this study focuses on VAW as a serious problem while demonstrating its further emergence during quarantine. This study also focused on the effects brought on by lockdown policies, including social and economic factors, and their implications in the increase of VAW during this pandemic.

West Nile Virus Chorioretinitis in the Presence of Negative Cerebrospinal Fluid Polymerase Chain Reaction Results

2021 ◽  
pp. 247412642097925
Author(s):  
Kareem Moussa ◽  
Karen W. Jeng-Miller ◽  
Leo A. Kim ◽  
Dean Eliott
Keyword(s):  
Cerebrospinal Fluid ◽  
West Nile Virus ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification ◽  
Sectional Study ◽  
Chain Reaction ◽  
West Nile ◽  
Cross Sectional ◽  
Positive Serum ◽  
Polymerase Chain

Purpose: This work aims to evaluate the utility of nucleic acid amplification testing (NAAT) and serology in confirming West Nile Virus (WNV) infection in patients with suspected WNV chorioretinitis. Methods: A retrospective cross-sectional study was conducted of a cluster of patients who presented to the Retina Service of Massachusetts Eye and Ear between September and October 2018. Results: Three patients were identified with classic WNV chorioretinitis lesions with negative cerebrospinal fluid NAAT and positive serum serology findings. The diagnosis of WNV chorioretinitis was made based on the appearance of the fundus lesions and the presence of characteristic findings on fluorescein angiography as previously described in the literature. Conclusions: This report highlights 3 unique cases of WNV chorioretinitis in which NAAT of cerebrospinal fluid failed to identify WNV as the inciting agent. These cases stress the importance of serum serologic testing in diagnosing WNV infection.

Comparison of Working Length Determination in Mandibular Single-Rooted Teeth

2021 ◽  
Vol 8 (2) ◽  
pp. 19-23
Author(s):  
Ruqayya Sana ◽  
Farzana Rehman ◽  
Farzana Rehman ◽  
Rashid Javaid
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Study Data ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Conventional Radiograph ◽  
Anterior Teeth ◽  
Working Length ◽  
The Mean ◽  
Electronic Apex Locator

OBJECTIVES: The objective of this study was to compare working length calculated with conventional radiographs and an electronic apex locator (IPEX II) during the root canal treatment of mandibular anterior teeth. METHODOLOGY: A cross-sectional study was done in the Department of Operative Dentistry, Sardar Begum Dental Hospital, Peshawar during February and March 2018. A consecutive sampling technique was used for sampling. Only 30 patients fulfilled the inclusion criteria of our study. Detailed medical and dental history was taken. Only patient fulfilling inclusion criteria were enrolled in the study. Data were analyzed using SPSS version 20. RESULTS: The mean age for patients was 45.33±5.16. 33% out of 30 patients (10) were male and 20 were females. The mean working length calculated from radiographs was 22.25±1.29 (min 20.09-max 24.10). The mean working length calculated by the electronic apex locator (IPEX II) was 22.17±1.28 (min 20.00-max 24.07). The mean difference between working length calculated by radiograph and electronic apex locator was -0.084mm, which means the working length determined by radiographs and by electronic apex locator has no difference in mandibular anterior teeth with single canals. CONCLUSION: Both the methods can be used effectively in endodontics for single-rooted mandibular teeth, but if both are used in combinations can lead to an improvement in the working length accuracy, which may significantly reduce the number of radiographs exposure, and increase the success and comfort for endodontic patients. KEYWORDS: Working Length, Apex Locator, Conventional Radiograph

Lumbar Cerebrospinal Fluid Opening Pressure Measured in a Flexed Lateral Decubitus Position in Children

PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 622-623
Author(s):  
Robert Ellis
Keyword(s):  
Cerebrospinal Fluid ◽  
Intrathecal Chemotherapy ◽  
Lateral Decubitus Position ◽  
Normal Range ◽  
Opening Pressure ◽  
Csf Pressure ◽  
Normal Ranges ◽  
Extended Position ◽  
Lateral Decubitus ◽  
Lumbar Cerebrospinal Fluid

Objective. Lumbar punctures in children are generally performed in a flexed position. Published normal ranges for cerebrospinal fluid (CSF) opening pressure require measurement in an extended position, and flexion is known to increase lumbar CSF pressure. This study sought to determine a normal range (mean ± 2 SD) for lumbar CSF opening pressure measured in a flexed lateral decubitus position in children. Methods. Opening pressure was measured in 33 children receiving diagnostic lumbar punctures or prophylactic intrathecal chemotherapy. Measurements were performed in a flexed lateral decubitus position. Patients with medical conditions affecting CSF pressure were excluded. Results. Opening pressure (mean ± SD) was 19.0 ± 4.4 cm H2O. Opening pressure was not significantly affected by patient age or sex. Intrathecal chemotherapy and sedation also did not affect CSF pressure. Conclusions. The normal range for lumbar CSF opening pressure measured in a flexed lateral decubitus position in children is 10 to 28 cm H2O.

scholarly journals Fetal Biparietal Diameter and Abdominal Circumference Ratio in Bangladesh

1970 ◽  
Vol 39 (1) ◽  
pp. 24-27
Author(s):  
Sabrina Q Rashid
Keyword(s):  
Polynomial Regression ◽  
Cross Sectional Study ◽  
Abdominal Circumference ◽  
Accurate Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Biparietal Diameter ◽  
First Time ◽  
Polynomial Regression Model ◽  
Growth Abnormality

This study was conducted to determine fetal biparietal diameter and abdominal circumference ratio in Bangladesh. There is still no table of this ratio in our country. A prospective, cross-sectional study was conducted on well dated, singleton fetuses of healthy pregnant women. One table and two graphs were prepared by fitting Polynomial regression model. Percentiles, mean and two standard deviations were derived of the ratio. Fetal charts of the raw data with superimposed fitted curves were constructed. The model showed a good fit to the data of 1223 subjects. It covered 95% of the population and gave 3rd, 10th, 50th, 90th and 97th percentiles. This chart can be useful for accurate assessment of fetal biparietal diameter and abdominal circumference ratio to determine the type of fetal growth abnormality, symmetrical or asymmetrical. This is the first time that this ratio has been studied in Bangladesh. Key words: Biparietal diameter; abdominal circumference. DOI: 10.3329/bmj.v39i1.6229 Bangladesh Medical Journal 2010; 39(1): 24-27

scholarly journals Butorphanol in Labour Analgesia

2018 ◽  
Vol 56 (214) ◽  
pp. 940-944 ◽  
Author(s):  
Jyotsna Yadav ◽  
Mohan Chandra Regmi ◽  
Pritha Basnet ◽  
K.M. Guddy ◽  
Balkrishna Bhattarai ◽  
...  
Keyword(s):  
Neonatal Outcome ◽  
Labour Pain ◽  
Cross Sectional Study ◽  
Labour Analgesia ◽  
Labor Pain ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Fetal Heart Rate Monitoring ◽  
Uterine Contractions ◽  
Pain Scores

Introduction: Labour is the process where uterine contractions lead to expulsion of product of conception through the vagina into the outer world. Labour pain is one of the most severe pains which has ever been evaluated and its fear is one of the reasons women wouldn’t go for natural delivery. Delivery is a painful experience for all of the women except a few of them. The labor pain results from some physiological-psychological causes. Different pharmacological and non-pharmacological methods have been tried for pain relief in labour. The objective of this study is to see the effect of butorphanol injection in labour pain. Methods: It is a descriptive cross-sectional study conducted in B.P. Koirala institute of health sciences. We observed 200 pregnant women meeting the inclusion criteria and giving the informed consent who were on 1 mg butorphanol i.m. at the onset of active stage of labour every 4 hourly and on demand. Pain assessment was done by Numerical Pain analogue scale measured from 1 to 10. Fetal heart rate monitoring was done according to the hospital protocol. Caesarean section was performed for obstetrical indication. Neonatal outcome was evaluated by on duty pediatrician and APGAR score were noted at 1 and 5 min.Results: The pain scores in first, second, third, fourth hour were (8.83±0.773), (9.84±0.544), (9.94±0.338), (9.6±0.298) respectively, where 1st and 2nd hour is statistically significant.Conclusions: Butorphanol is an effective labour analgesia without significant adverse effects on women and the neonatal outcome.

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